MedicaidBilling CodesHigh impact
Newsletter Vol. 2, No. 42
New Jersey Medicaid·NJ · Pathology·Medical Policy
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid has updated the Independent Clinical Laboratory Services Manual with additional HCPCS procedure codes and revised Maximum Fee Allowance Schedule rates for laboratory and pathology services. Billing teams must immediately replace their current subchapter with the attached updated version to ensure accurate reimbursement for independent clinical laboratories.
Action Required
Immediately: Billing team and laboratory management must locate and delete the previous Subchapter HCFA Common Procedure Coding System (HCPCS) in the Independent Clinical Laboratory Services Manual and replace it with the attached updated subchapter. Verify all laboratory billing codes in the practice management system match the new HCPCS codes and Maximum Fee Allowance Schedule rates listed in the updated subchapter. Communicate the updated fee schedules to all staff involved in claims submission and coding. Claims submitted using outdated codes or rates will be subject to denial or adjustment by New Jersey Medicaid. Contact Phyllis Valeri Bruschini, Consultant at the Office of the Medical Director, if clarification is needed on specific codes or reimbursement rates.